摘要:

ABSTRACTMany diseases in childhood present with symptoms resulting from the effects of those diseases on gut motility, including vomiting, colicky abdominal pain, ileus, constipation or diarrhoea. The control of gastrointestinal motility has been the subject of intensive research. It is now recognized that motility in the gastrointestinal tract is influenced by a complex range of factors, not only involving intestinal musculature, but also neural and humoral control. The development of techniques to measure motor activity in the gastrointestinal tract has increased our understanding of the pathophysiology of motor disorders. Manometric techniques are now available to study motility in pharynx, oesophagus, stomach, the biliary tract small and large intestine, and anorectum.The following discussion provides a background to the use of manometry in the study of motor disorders affecting the gut and will focus on the oesophagus and anorectum.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00335.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTCough is the commonest symptom of childhood respiratory disease and at times may be the predominant feature. The characteristic sound of the cough is often considered by the clinician as a useful diagnostic feature in such conditions as croup and whooping cough. This has prompted a closer study of the physical basis of the cough sounds and their relationship to the pathological processes in the airway.1Kelemanet al.2have demonstrated that there are at least three phases to any particular cough, that is, an initial burst due to air turbulence and tissue vibration, followed by a noisy phase, and the final vocalic burst as the glottis forcefully cuts off the air flow. These studies have led to the development of computer assisted methods of evaluation of cough.3In turn, sound spectral analysis techniques, which have been used extensively to study lung sounds in asthma,4have been applied to cough sounds.5,6A microcomputer‐based system which allows rapid performance of such analyses has been devised and described recently

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00336.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTIn this review the technical aspects of inhaled therapy will be considered, as well as the more common uses of inhaled therapy in paediatrics.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00337.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe importance of providing adequate analgesia for children in pain was highlighted by a recent annotation in this journal.1Newborn infants as well as children fare better after surgery if adequate analgesia is provided.2The sick newborn infant who has not had surgery but who is receiving assisted ventilation and multiple invasive procedures may also fare better with analgesia, but this topic has received little attention despite the large number of babies who receive this treatment in newborn intensive care units. This manuscript reviews the evidence of what constitutes a ‘painful’ stimulus to a newborn infant and details options for analgesic treatment. Some issues are raised that may dictate the direction of necessary future resea

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00338.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00339.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTIt is a privilege and an honour to deliver this, the Turner Gibson Oration for 1989. I chose the title of my lecture because glucose, as the essential substrate for brain function, is indeed the fuel for our thoughts. Although important at all ages, it has a particular significanice for the young child, since a normal supply of glucose is essential to protect brain development and hence the potential for thought in the child's brain. Thus, glucose should have a high priority in our own thinking as paediatricians. With this in mind, the purpose of my lecture is to fuel your own thoughts on your management of children who have disordered glucose homeostasis by examining controversy, challenging current dogma and providing new information.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00340.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractSix very low birthweight neonates with terminal respiratory failure due to severe hyalline membrane disease who failed to respond to conventional ventilation were offered a trial of high frequency jet ventilation using the volumetric diffusive respirator (VDR). All neonates showed improvement in pulmonary function. Two neonates were weaned successfully from high frequency ventilation. The results of this initial trial suggest that the volumetric diffusive respirator is a safe and effective method of ventilation in neonates with respiratory failure and that the survival rate in such neonates might be enhanced if treatment is introduced earlier in the disease.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00341.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThe incidence, clinical presentation and severity of bronchopulmonary dysplasia (BPD) in 110 consecutive very low birthweight (VLBW) infants admitted to the National University Hospital Neonatal Intensive Care Unit between October 1985 and January 1989 is reviewed. Thirty‐two infants died, giving an overall survival rate of 70.90%. Sixty infants (54.4%) required mechanical ventilation in the first week of life; 24 (40%) of these infants died. Of the 36 survivors, 23 required oxygenation at 28 days of life and 21 fulfilled the criteria for BPD (35% of the 60 ventilated and 58% of the survivors). The incidence of BPD in all VLBW infants is 19% and of VLBW survivors 27%. Birthweight and gestational age appear to be important determinants. All the survivors in the 501‐750 g birthweight group developed BPD compared to 6.25% in those above 1250 g. None of those>30 weeks gestation developed BPD.Two forms of BPD were observed; the ‘severe’ group presented radiologically with chest radiographs characteristic of Stage IV BPD, while the ‘mild’ group with small or normal sized lungs demonstrated irregular strands of radio‐densities alternating with areas of normal or increased lucency. The duration of mechanical ventilation and oxygen dependency were significantly longer in the ‘severe’ group, with the mean maximum peak inspiratory pressure, mean airway pressure, andFio2required in the first week of life being also significantly higher.Hyaline membrane disease was the main cause of respiratory failure requiring ventilation. The other causes were persistent pulmonary hypertension (1) and apnoea of prematurity (3); all of the latter developed only mild BPD.Those who developed BPD required a significantly longer period of hospitalization, a longer period to regain their birthweight and attain a weight of 2 kg, and a higher incidence of retinopathy of prematurity compared with those without BPD even after correcting for the earlier gestational age

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00342.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractAntinuclear antibody (ANA) immunofluorescence tests, using HEp‐2 cells, were performed on 100 children without a history of connective tissue disease. Eighteen (18%) were positive at titres<1:40, nine (9%) being greater than 1:160. Interlaboratory variability was demonstrated with some specimens. No association with possible intercurrent infection was found to account for positive results. Of 44 children with proven infections five (11%) were positive. Antinuclear antibody may be found in some normal children when using the sensitive HEp‐2 cell substrate, and in the absence of clinical features should not necessarily suggest the presence of a connective tissue dise

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00343.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractWe report a boy with acute lymphoblastic leukaemia (ALL) treated with chemotherapy and prophylactic cranial irradiation to a dose of 24 Gy. Six years after diagnosis he developed a glioma and died. Prior to 1979, four cases of second malignant neoplasm (SMN) of the brain had been reported in children treated for ALL. These SMNs occurred within 2 years of the original diagnosis (median 1.3 years) and at least two of four patients had not received prior radiotherapy. Since 1979. 28 cases of SMN of the brain have been reported including nine of 468 (1.9%) long‐term survivors in one study. All occurred more than 3.7 years from diagnosis (median 6.5 years; range 4‐13 years) and all received cranial irradiation (median 24 Gy; range 20‐48 Gy). These data indicate a change in the pattern of SMNs which is most likely due to the introduction of cranial irradiation. As well, the frequency of SMNs in children treated for ALL appears to have increased, although it is still no greater than the risk of SMNs developing following the treatment of any other primary childhood neo

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00344.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY